Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.
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by periodical manipulations, so as to insure the limb being thoroughly put through all its natural movements daily, once at least, or oftener; and by a studied use of the member, so as to favor relaxation, or coerce elongation of the contracted parts, and to acquire strength in those of that set which are weakest. By the use of such means, it is my experience, the greater number of paralytic or spastic contractions that are acquired during childhood and adolescence (growth) may be obviated or arrested from being worse ; the exceptions being cases in which a more than usually severe paralysis, or an active tonic spasm, affects some or all of the principal muscles. Mark, — so long as the medical practitioner has simply to do with paralysis or spasm, and an amount of contraction susceptible of yielding to the pressure of the hand, or even to the moderate use of some comfortable mechanical contrivance, calculated to main- tain the member by times in a proper position, the rational sur- geon will not affirmatively entertain the question of " division of tendons; " for, surely, the division of muscles affected with pa- ralysis, or with spasm, is no cure for these diseased states. In- deed, in many instances the contracted muscle is a healthy mus- cle, shortened merely from want of action in its antagonists; and it is certainly inconsistent with sound therapeutics to en- deavor to reduce by tenotomy a healthy muscle to the equal condition of a paralyzed one. Moreover, the apparent benefit derived from division of the tendon of a muscle, itself being healthy, but possessing an in- convenient activity, is only temporary; for after a few months' time, the muscle (in children) re-contracts, unless the practi- tioner has determined to prevent the healthy muscle recovering tone after its division, by sedulously keeping the ends of the divided tendon as far as possible asunder — an effort often frus- trated by nature, causing sloiv contraction in the newly-inter- posed or uniting medium. Instead of operating by tenotomy, in such cases, we are bound rather to exhaust all legitimate modes of counteracting the paralysis ; remembering that during childhood and growth, there is ever hope of at least partial re- covery from the paralysis. But when the case may be justly